Dispersed Services Policy Position and Guidance Publication code: OPS-0816-374 Publication date 23 August 2016 Version number 1 Author s initials HD/HM Job title DO Responsibility for this document HSS/Care at Home Expert Group Review date February 2017 Page 1 of 5
1. Context and purpose This guidance is intended to clarify the parameters of registration for dispersed services. It has been produced to support Care Inspectorate staff determine whether a service is a dispersed service. The Public Services Reform (Scotland) Act 2010 (The Act) and associated Regulations inform the context and purpose of this policy and guidance.the Scottish Regulators Strategic Code of Practice and the duty of promoting sustainable economic growth have been taken into account in developing this policy. 2. What is a dispersed service? A dispersed service describes the situation where a manager is responsible for a single care service that operates from more than one location or by more than one team. This guidance applies to housing support, support service care at home, nurse agencies and childcare Agencies. This guidance does not apply to premises based services, such as Care Homes, day care of children. The care service has a single registration and the service as a whole is subject to inspection. We do not intend the dispersed service approach to support any reduction in the number of managers appointed by providers, nor the number of care services that a single manager can oversee. We intend it to support dispersed services and reflect diverse organisational structures. 3. Our policy position:. The Care Inspectorate will NOT automatically set limits on the size of the dispersed services and/or where the service would be able to operate. However, parameters can be applied through the use of conditions where this is determined by us to be helpful or appropriate. In order to determine whether the service is a dispersed service the following criteria is to be applied. Criteria 1: The manager is in day-to-day charge It is acknowledged that managers perform various functions and it is not expected that the service manager has to be on site and available to all staff on a 24 hour basis. Therefore, to evidence that the named manager for the care service is in day-to-day charge we expect all of the following indicators to be met. 1. The provider must consider the sizes of the different units and their geographical spread to ensure one individual can reasonably manage the dispersed service locations. The manager must be responsible for the day-to-day operation of the service and accountable for all aspects of the service. 2. The manager has daily contact with the staff in the service s various locations and is accessible on a day-to-day basis. Contact does not require to be face to face on a daily basis but reasonable arrangements for face-to-face contact must be in place and demonstrated by the provider. Page 2 of 5
3. The manager does not share the management role (with the exception of formal job share positions) although they may have senior staff/depute who have clear roles and responsibilities. Staff who regularly deputise for the manager must be appropriately registered with the SSSC. This may require staff to be registered as both a supervisor and practitioner if regularly acting in these roles. 4. The manager must be available to respond and provide support to staff in an emergency. There must be clear emergency systems/on call arrangements in place in the service. There must be sufficiently skilled and qualified staff to deal with emergencies when the manager is on leave or otherwise unavailable 5. The job description must reflect the duties of the manager of the dispersed service 6. Registered manager should be no more than four tiers away from service users. In some flat structures the manager may be operating at tier 2 or 3. 7. Managers will have relevant management skills required of their post and may line manage supervisors who have the necessary specialist skills and experience of working with the identified client group/s. In this example, the senior manager is likely to be the registered manager. Tiers Management Structure People who use care services 1 Support Worker/Care Worker 2 Team Leader 3 Depute Senior 4 Senior Manager Regional Manager Criteria 2 : Single care service Page 3 of 5
The provider must operate each part of the care service in the same way; it must be operated as a sole care service in line with its aims and objectives and not a number of different services. The indicators we will consider to evidence that it is a single care service are: 1. The different parts of the service share the same care service name 2. The service is required to have clear aims and objectives setting out who the service is for and the expected outcomes are. The different parts of the service will share the same aims, objectives, statement and purpose, policies and procedures. Criteria 3: Ability to comply with the Act, Regulations and National Care Standards The provider must also satisfy us of their ability to comply with the Act, Regulations and the relevant National Care Standards in the event the dispersed service arrangement was to be put in place. The onus is on the provider to evidence this. There are a number of factors we will take into account, such as: any relevant previous regulatory history of the provider and/or care service any relevant previous grading history held by the care service, or where it relates to a new application for registration, any previous grading history the provider has had with any previous care services, in particular with regard to management and leadership any relevant potential impact the proposed arrangements may have on welfare and safety of service users. This is not intended as an exhaustive list and other factors may be taken into account the provider will have an opportunity to provide comment and documentary evidence on any matter we take into consideration. 4. Applying conditions As stated in section 2 above, the dispersed service arrangements were introduced to reflect and support the way service operate. It is not to be used by providers who wish to avoid registration of new services, as a mechanism simply to reduce the number of managers, or number of registered services and reduce the associated costs. Where a service cannot evidence that it is a dispersed service, we will refuse the variation or registration. Where it is agreed that the proposed service meets the criteria, it may still be appropriate to discuss the client group, size, geographic spread and or numbers of staff, teams or numbers of service users and limitations to the conditions of registration may be applied. 5. Implications Registering a dispersed service may have a number of implications, for instance: 1. As a single service, the provider will only receive one certificate of registration 1 1 With the exception of combined housing support services and support services (care at home) which are two care service categories operating in a combined way and will have separate certificates of registration for each service category. Page 4 of 5
2. Conditions of registration will reflect that this is a dispersed service operating from different locations, and will list each office location. 3. The provider must be able to demonstrate to service users that the service is registered, and copies of the certificate must be displayed in all appropriate locations of the service so that service users are clear as to the name of the service and by whom it is being provided 4. We may inspect any part of the service. One report will be produced. Any recommendations made, or enforcement action taken (including requirements, improvement notice or other formal enforcement) following complaint or inspection activity, will apply to the service as a whole. Similarly grades will apply to the service as a whole. As such, poor standards identified in one location will result in enforcement action/lowering of grades to the service as a whole. Examples of dispersed services Blind and Deaf Services Scotland This service has a manager located in Edinburgh and 5 support staff who are based in different parts of Scotland (Glasgow, Elgin, Dunfermline, Irvine, Inverness). Staff all have the same job descriptions, same training and they all support individuals with practical issues relating to their accommodation. Shire Housing Association Shire provides low intensity support to older people living in 150 sheltered housing developments. Rather than registering each sheltered housing development separately, we used the dispersed policy guidance. The organisation has three area managers and it was agreed that they would be the named registered managers having responsibility for 50 developments each. Page 5 of 5